Ongoing sexually transmitted disease acquisition and risk-taking behavior among US HIV-infected patients in primary care: implications for prevention interventions
Kenneth H Mayer, Timothy Bush, Keith Henry, Edgar T Overton, John Hammer, Jean Richardson, Kathy Wood, Lois Conley, John Papp, Angela M Caliendo, Pragna Patel, John T Brooks, SUN Investigators, John T Brooks, Pragna Patel, Lois Conley, Tim Bush, Kathleen Wood, Rose Baker, Cheryl Akridge, John Hammer, Tara Kennedy, Barbara Widick, Billie Thomas, Ken Lichtenstein, Cheryl Stewart, Keith Henry, Jason Baker, Edie Gunderson, Miki Olson, John Hall, Frank Rhame, Mark Olson, Eve Austad, Hal Martin, Meaghan Morton, Cheri Murch, Charles Carpenter, Susan Cu-Uvin, Kenneth Mayer, Erna Milunka Kojic, Lynn Taylor, Jennifer Florczyk, Sara Metzler, Patricia D'Aiello, E Turner Overton, Lisa Kessels, Mariea Snell, Dorothea Dedeaux-Turner, Sara Hubert, Kenneth Griffie, Kenneth H Mayer, Timothy Bush, Keith Henry, Edgar T Overton, John Hammer, Jean Richardson, Kathy Wood, Lois Conley, John Papp, Angela M Caliendo, Pragna Patel, John T Brooks, SUN Investigators, John T Brooks, Pragna Patel, Lois Conley, Tim Bush, Kathleen Wood, Rose Baker, Cheryl Akridge, John Hammer, Tara Kennedy, Barbara Widick, Billie Thomas, Ken Lichtenstein, Cheryl Stewart, Keith Henry, Jason Baker, Edie Gunderson, Miki Olson, John Hall, Frank Rhame, Mark Olson, Eve Austad, Hal Martin, Meaghan Morton, Cheri Murch, Charles Carpenter, Susan Cu-Uvin, Kenneth Mayer, Erna Milunka Kojic, Lynn Taylor, Jennifer Florczyk, Sara Metzler, Patricia D'Aiello, E Turner Overton, Lisa Kessels, Mariea Snell, Dorothea Dedeaux-Turner, Sara Hubert, Kenneth Griffie
Abstract
Background: To better understand the factors associated with HIV- and sexually transmitted disease (STD)-transmitting behavior among HIV-infected persons, we estimated STD prevalence and incidence and associated risk factors among a diverse sample of HIV-infected patients in primary care.
Methods: We analyzed data from 557 participants in the SUN Study, a prospective observational cohort of HIV-infected adults in primary care in 4 US cities. At enrollment and 6 months thereafter, participants completed an audio computer-assisted self-interview about their sexual behavior, and were screened for genitourinary, rectal, and pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis infections by nucleic acid amplification testing, and for serologic evidence of syphilis. Women provided cervicovaginal samples and men provided urine to screen for Trichomonas vaginalis by polymerase chain reaction.
Results: Thirteen percent of participants had a prevalent STD at enrollment and 7% an incident STD 6 months later. The most commonly diagnosed infections were rectal chlamydia, oropharyngeal gonorrhea, and chlamydial urethritis among the men and trichomoniasis among the women. Other than trichomoniasis, 94% of incident STDs were identified in men who have sex with men. Polysubstance abuse other than marijuana, and having ≥4 sex partners in the 6 months before testing were associated with diagnosis of an incident STD.
Conclusions: STDs were commonly diagnosed among contemporary HIV-infected patients receiving routine outpatient care, particularly among sexually active men who have sex with men who used recreational drugs. These findings underscore the need for frequent STD screening, prevention counseling, and substance abuse treatment for HIV-infected persons in care.
Conflict of interest statement
No conflict of interest exists for any of the authors.
Source: PubMed